Part D Enrollment at Hospital Discharge Did Not Improve MI Outcomes

(HealthDay News) — For patients with acute myocardial infarction, enrollment in Part D by hospital discharge is not associated with improved outcomes, according to a study published in Circulation: Cardiovascular Quality and Outcomes.

Abhinav Goyal, MD, from the Emory University School of Medicine in Atlanta, and colleagues describe trends in Medicare Part D enrollment in 59 149 Medicare beneficiaries discharged after acute myocardial infarction (MI). After adjustment for patient and hospital factors, the researchers compared 30-day and 1-year outcomes (all-cause death, all-cause readmissions, and major adverse cardiac events) among Part D enrollees (49.5%) and non-enrollees.

The researchers found that enrollees more often had all-cause 30-day death (4.0% vs 3.3%), but after multivariable adjustment this association was not statistically significant (adjusted hazard ratio [HR]=1.06; 95% CI, 0.97-1.17).

The unadjusted risks for 30-day all-cause readmission or major cardiac events, and for 1-year mortality, all-cause readmission, or major adverse cardiac events, were also increased for enrollees, but after multivariable adjustment these correlations were attenuated.

Among Part D enrollees, secondary prevention medication adherence remained low at 1 year post-discharge.

“Only half of Medicare-insured patients with acute MI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from non-enrollees,” the researchers wrote. “There remain opportunities for improvement in medication adherence among patients with prescription drug coverage.”